US surgeon general declares gun violence an urgent public health crisis

Gun violence in the United States is an urgent public health crisis that demands the “collective commitment of the nation” to stop it, Surgeon General Dr. Vivek Murthy says in a new advisory released Tuesday.

It’s the first time a publication from the Office of the Surgeon General has focused on firearm violence and its “profound consequences” on survivors, communities, and mental health. A surgeon general’s advisory is typically used to draw attention to significant public health challenges, according to the US Department of Health and Human Services. Typically, advisories are shorter than surgeon general reports, such as a well-known 1964 report about the dangers of smoking, which include a comprehensive scientific review documents.

Tuesday’s advisory spells out how devastating gun violence has been in the United States and details how public health strategies can help.

In 2022 alone, more than 48,000 people in the US died from firearm-related injuries, according to provisional data. That number included homicides, suicides and unintentional deaths.

The rate of firearm-related deaths in the US has been rising, according to the advisory, reaching a three-decade high in 2021. Since then, data has shown a decrease in gun-related homicides, while the number of gun-related suicides have stayed about the same, the advisory says.

While mass shootings are still rare, making up just about 1% of gun deaths, the number of mass shooting incidents has been rising, according to the advisory.

A KFF poll in April last year also showed that gun violence is all too common in the lives of Americans. More than half of adults that live in the US report that they or their loved ones have experienced a firearm-related incident. One in five adults say they have personally been threatened with a gun, and nearly the same number said that a family member was killed by a gun. That last number included those who used a gun in a suicide.

People of color are disproportionately impacted by gun violence, the surgeon general’s advisory says. In 2022, Black people saw the highest rates of firearm-related homicides across all ages.

That same year, Black children and adolescents made up half of all firearm deaths, despite being only 14% of this demographic, the advisory says. The violence isn’t just a direct physical threat: It can threaten an entire communities’ sense of well-being and can lead to elevated levels of stress and mental health problems.

Children ages 1 to 19 die from guns more than anything else in the US, studies show.

Children, in general, faced the highest gun violence mortality rate among peer countries by far. In the US, there were 36.4 deaths per million people ages 1 to 19; in Canada, its 6.2 per million, in Australia, it’s 1.6 per million and in the UK, it’s 0.5 per million.

An analysis of unintentional firearm deaths among children and adolescents found that 56% of these incidents happened in the child’s own home. Part of the problem is the way firearms are kept: Among the incidents where the details were known, 74% of the firearms were stored loaded and 76% were stored unlocked. Most commonly, guns were found in sleeping areas, such as in nightstands, under a pillow or mattress or on a bed.

In addition to the physical problems such violence can cause, firearm violence can also take a toll on mental health, the advisory says. Fears about gun violence are particularly common among children, the advisory says, and many worry that they will experience such violence at school.

Public health leaders will have to address the country’s high suicide rate, according to the advisory. More than half of gun deaths in 2022, 56%, were from suicide.

Unlike with homicides, the highest rate of gun suicides for adults 45 years and older involved White people. For younger people, those who identified as American Indian or Alaska Native had the highest rate of gun suicides.

In 2021, the suicide rate for men who are veterans was 62.4% higher than for men who are not veterans. It was 281.1% higher for women who are veterans compared with women who are not.

The advisory says more money needs to be dedicated to firearms research to understand how to reduce and prevent firearm violence in the US, and investments must target better data collection and prevention strategies. The advisory urges communities and health-care systems to step up to help populations that are particularly vulnerable to this kind of violence.

The advisory also calls for more gun laws, including requirements for safe and secure firearm storage, a ban on assault weapons, universal background checks and effective firearm removal policies. It also says firearms should be treated like any other regulated consumer products, such as cars or pesticides.

“There are no federal standards or regulations regarding the safety of firearms produced in the US,” the advisory says. “Firearms manufactured and sold in the US may not undergo safety testing or include safety features like warning labels related to associated risk or authorized-use technology (“smart” firearm technology) for firearm access. Treating firearms as a consumer product could result in changes which may enhance safety.”

This is not the first advisory Murthy has issued. A 2021 advisory detailed the spate of mental health problems people faced, and a separate advisory explained how Americans could confront a rash of health misinformation. Last year, Murthy issued another advisory on the effects of social media on youth mental health.

A public health approach can turn the tide on gun violence, the advisory says, just as it did for tobacco-related disease and motor vehicle crashes.

“It is up to us to take on this generational challenge with the urgency and clarity the moment demands,” the advisory says. “The safety and well-being of our children and future generations are at stake.”

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